Sexual Satisfaction Survey for Married Couples

This survey is to be completed by married individuals only

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Sexual Satisfaction for Married Individuals 1. Gender Male Female 2. Marital Status Married and living together Married and living apart Divorce pending but living together Separated but still sexually involved 3. Years of Marriage 0-9 Years of Marriage 10-15 Years of Marriage 16-20 Years of Marriage 21-25 Years of Marriage 26-30 Years of Marriage 31-35 Years of Marriage 36-40 Years of Marriage 41-45 Years of Marriage 46-50 Years of Marriage 51-55 Years of Marriage 56-60 Years of Marriage 61-65 Years of Marriage 66-70 Years of Marriage 71-75 Years of Marriage 76-80 Years of Marriage 80 Plus Years of Marriage 4. How would you rate your level of overall sexual satisfaction with your spouse? I am very, very satisfied I am satisfied I am not so satisfied I am am not satisfied 5. I would like my spouse and I to have sex More often Less often Not at all It does not matter. I am happy the way it is right now 6. My partner has a medical problem that's causing problems in our sexual relationship Yes No 7. I have a medical problem that's causing problems in our sexual relationship Yes No 8. Has your spouse ever fulfilled your greatest sexual desire (required) Yes No 9. How often do you obtain climax (orgasm) during sex? (required) Every time we have sex Most of the time we have sex Some of the time we have sex Very rarely Not at all 10. Is your partner responsive to your need to have full satisfaction during sex (required) Yes No 11. How often you would like to have sex to be fully satisfied (required) Every day At least three times a week At least twice a week At least once a week About three times a month About once every six week Four times a year Once a year When ever . . . It does not matter 12. Would you take medication (prescription or natural) to enhance your sex drive is necessary? (required) Yes No 13. Are yo using any medication (prescription or natural) or food right now to help boast your sex drive (required) Yes No 14. If you are using medication (prescription or natural) or food to boast your sex drive please list below 15. I will share this survey with married couples I know. Yes No Current Results